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We study human autoimmunity; in particular we aim to understand why autoimmunity often occurs during recovery from T cell lymphopenia.

People with multiple sclerosis, treated with the highly effective lymphocyte depleting antibody alemtuzumab offer a rare opportunity to study this phenomenon directly in humans, as 1 in 3 patients develop a new autoimmune disease after treatment (mainly thyroid). Using this “human model” we have shown that rebound T cell reconstitution via the proliferation of cells that have escaped depletion is antagonistic to tolerance. We now ask:

1) Can autoimmunity after alemtuzumab be reduced by promoting T cell production via the thymus? In collaboration with Alasdair Coles, we are testing this approach in an MRC-funded trial (CAMTHY).